Although many studies have been conducted to survey illegal drug use in America, no research has been done in the past generation on the prevalence of illegal/legal drug use, other associated diseases or disorders, or types of treatment, if any, which may have been used.
Therefore, this study funded in part by the National Institute of Health was a milestone in epidemiology to look at Americans and what drugs were being used, and what are the characteristics of those who use the drugs.
Over 10% of Americans reported either drug abuse or dependence within their lifetime. Two percent of Americans reported currently using drugs.
Important to note, is that the 10% of those abusing or dependent on drugs, does not include others who use these drugs recreationally but are not dependent or abusers. A much higher percentage of the American population would be identified, if all users were included. Instead, this study only looked at those people who met the DSM-IV criteria.
The DSM-IV is used by psychiatrists and psychologists to diagnose their patients; therefore, its use in this study lends validity to the findings. Government agencies, physicians, and the public can feel confident in changing policies or treatment parameters based on the results.
The DSM-IV defines substance abuse as meeting at least one of the seven criteria identified below. Substance dependency is defined as meeting three or more of the criteria identified below.
- Substance tolerance: A person needs more of the substance to achieve the desired effect, or the effect is significantly diminished with the same amount of drug used in the past
- substance withdrawal symptoms: Symptoms present within hours or a few days of stopping the drug (i.e. tremors, agitation, anxiety, nausea, vomitting, seizures, hallucinations and/or insomnia)
- Substance was taken in larger amounts or over a longer period of time than intended
- Persistent desire or unsuccessful attempts to decrease or eliminate the drugs were tried
- Great deal of time was used in taking the drug and/or in recovering
- Important social, recreational or occupational activities were given up as a result of the drug use
- Drug use is continued, despite the knowledge that it will cause signficant psychological or physiological harm
Drugs used included the following:
- sedatives,
- tranquilizers,
- prescription opiates,
- stimulants,
- hallucinogens,
- marijuana,
- cocaine (including crack cocaine),
- inhalants/solvents,
- heroin, and
- other drugs.
Groups who were more likely to be involved with drugs were:
- men,
- Native Americans as opposed to other ethnic groups,
- those ages 18 to 44 years,
- people with lower socioeconomic status, and
- those who never married or who were widowed, separated, or divorced.
However, with few exceptions, drug use was significantly related to the following 'co-morbidities' (i.e.diseases or disorders):
- alcohol use
- nicotine dependence
- mood, anxiety or personality disorders
Amazingly, even though effective treatments exist for drug use and/or dependence very few sought help (only 8.7% of drug abusers and approximately 37% of those dependent on drugs, sought treatment). There was no relationship between any socioeconomic, gender, race, marital status or age and whether help was sought or not.
Interestingly, those people with a psychiatric diagnosis were the most likely to seek help; not for their psychiatric problem, but their drug use. They also were the least likely to adhere to their treatment plan due to their associated mental illness, which was not treated simultaneously.
In conclusion, the results of this study indicate that there is a high percentage of Americans who either abuse or are dependent on drugs. This disabling illness not only costs the individual, but the family and society as a whole. Much more attention is needed to educate the public, physicians and policy makers about this crippling disease.
Michigan Department of Community Health; 2003
http://www.michigan.gov/documents/SystemResponsestoSubstanceAbuseTreatmentNeeds_77114_7.pdf
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